Fatigue DDx

Fatigue – Differential Diagnosis

Common causes

• Anxietyand Depression
• Stress, poor sleep, overwork
• Anaemia
• Hypothyroidism
• Chronic fatigue syndrome
• Chronic infections

Must Not Miss

• Malignancy
  • Lymphoma
  • Leukaemia
  • GI tract cancer
  • Pancreatic Cancer
• Diabetes
• Cardiac failure
• Renal failure

Easily missed

• Medication
• Obstructive sleep apnoea
• Addison’s disease
• Cushing’s syndrome
• Connective tissue diseases
• Polymyalgia rheumatica
• Myasthenia gravis
• Coeliac disease
• HIV

Red flags

• Systemic features (weight loss, anorexia, fevers, night sweats and lymphadenopathy)
• Localising red flags
  • Haemoptysis/ Dyspnoea
  • Jaundice
  • New onset Dyspepsia > 50 years old
  • Dysphagia
  • Persistent altered bowel habit
  • Rectal bleeding
  • Haematuria
  • Breast lump
  • PMB
• Polyuria and polydipsia
• Positive examination findings

Investigations to consider

• FBC, CRP/ESR, Glandular fever screen
• U+Es, LFTs, TFTs, Bone profile, Serum glucose
• Coeliac screen, CK, BNP, Auto-antibody screen
• Serum cortisol
• HIV screen
• Urinalysis/MSU
• ECG
• CXR